You may use this form if you received a notice that your monthly Medicare Part B (medical insurance) or prescription drug coverage premiums include an income-related monthly adjustment amount …

Fill out the Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event (SSA-44) (PDF) form. Fax or mail your completed form and evidence to a Social Security office.

Submitting Forms and Supporting Documents You can electronically complete, upload, and submit select forms to Social Security using the Upload Documents feature. You can also fax or mail any …

Apply for Medicare Medicare Publications Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event, (Form SSA-44) Apply for Medicare Part D Extra Help program Other Medicare …

Use Form Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event to report a major life-changing event. If your income has gone down, you may also use Form SSA-44 to request …

Jun 18, 2013 · NOTE: Beneficiaries may use the optional Form SSA-44 (Medicare Income-Related Monthly Adjustment Amount – Life-Changing Event) to report a life-changing event with a significant …

Jun 10, 2024 · If the beneficiary alleges their spouse has or will have a work stoppage that will significantly reduce their MAGI for the current tax year, SSA will need MAGI and tax filing status …

Feb 23, 2009 · If the beneficiary states their spouse has a work reduction that will change their MAGI for the current tax year, SSA will need MAGI and tax filing status information for the tax year they are …

https://secure.ssa.gov/eSubmit/upload-documents-ui/start Upload Documents and Submit Online Forms What to Do if You Have Trouble Signing Back in? If you cannot sign back in to Upload Documents, …

Other ways to complete this task Upload your request for reconsideration Sign in and search for Request for Reconsideration (SSA-561-U2) (PDF). Then, complete the form, save it to your device, …